CASE STUDY: Preschool Child: Ricky
Ricky, age 4 years, arrives in the clinic with his mother. Ricky lives with his mother and father,
who both work full-time, and his infant sister. Their extended family lives in a different state
more than 100 miles away. Both parents are of average height and in good health. Ricky’s
mother mentions that Ricky often expresses frustration, particularly in regard to food. Conflict
over food occurs every day. Mealtime is a battle to get him to eat, unless his mother feeds him.
Ricky’s baby sister seems to tolerate all baby foods but requires her mother to spoon-feed.
Ricky’s mother is quite frustrated and concerned that he will become malnourished.
Reflective Questions
1. What additional assessment information would you collect?
2. What questions would you ask, and how would you further explore this issue with the
mother?
3. In what ways does the distance of the extended family influence this family’s approach
to health promotion?
4. What factors would you consider to determine whether malnourishment is a factor in
this family?
Sample Solution
Additional assessment information that may be collected include Ricky’s growth and development history; the types and quantities of food he is eating; his activity level; any health conditions he has been diagnosed with or has a family history of; his sleeping patterns, toiletry habits, and other behavioral issues. Questions to further explore this issue with the mother may include how long she has noticed difficulties at mealtime, what strategies she has tried to encourage him to eat, whether there are certain foods he prefers or rejects, if there are any potential triggers for his behavior during mealtimes (such as a desire for independence), and what other interventions she might have attempted already.
The distance between Ricky's extended family can influence the family's approach to health promotion in various significant ways. The absence of close relatives who could provide support and guidance on nutrition could potentially lead to inadequate dietary practices in regards to Ricky's diet due to lack of knowledge or resources. Additionally, travel costs may prevent them from accessing medical services needed for regular check-ups or illnesses that could contribute directly or indirectly towards poor nutrition. Moreover, not having a strong social network nearby can also be linked with increased stress levels which may also contribute towards nutritional imbalances in children.
To determine whether malnourishment is a factor for this family, factors such as the quality and quantity of food consumed by Ricky should be considered alongside more general indicators including physical growth parameters like height and weight which can help assess adequate nutrition status when compared against normal ranges based on age group criteria set out by governmental agencies such as WHO (World Health Organization). A blood test would reveal micronutrient profiles that could reveal deficiencies related to vitamins or minerals which are essential components required for proper growth rates in young children. Other physiological biomarkers such as cholesterol levels should also be monitored regularly along with ensuring adequate hydration throughout the day by providing access both water/fruit juices without additional sugar additives